title: Impact of a tenofovir disoproxil fumarate plus ritonavir-boosted protease inhibitor-based regimen on renal function in HIV-infected individuals: a prospective, multicenter study.
abstract: BACKGROUND
  The aim of this study was to investigate the impact of a tenofovir disoproxil fumarate (TDF) plus ritonavir-boosted protease inhibitor (PI/r) regimen on renal function in Chinese HIV-infected patients.
  
  
  METHODS
  Seventy-five HIV-1 infected patients failing first-line antiretroviral therapy (ART) comprised the TDF+PI/r group. Seventy-five HIV-1 infected patients matched for gender, age, and renal function made up the control. All subjects completed follow-up visits over 48 weeks. CD4 cell count, plasma HIV-1 viral load, and urine protein level were assessed at the trial start (baseline, week 0) and at week 48. The serum creatinine and estimated glomerular filtration rate (eGFR) were monitored at each follow-up point. Change in eGFR from baseline to week 48 was also compared.
  
  
  RESULTS
  Compared to control, the TDF+PI/r group exhibited higher levels of serum creatinine (79 vs. 69.7 μmol/L, P<0.001) and a lower rate of eGFR (93.0 vs. 101.6 ml/min/1.73 m², P=0.009) at the end of week 48. Patients treated with TDF+PI/r showed greater decline in eGFR than control (-8.8 vs. 6.4 ml/min/1.73 m², P<0.001). Compared to baseline renal function of the control group, the TDF+PI/r group exhibited a greater median decline in eGFR at the end of week 48 (P<0.001).
  
  
  CONCLUSIONS
  We found that a TDF+PI/r based ART regimen resulted in greater renal function decline over 48 weeks. Therefore, renal function should be monitored especially when TDF is used in combination with PI/r.
  
  
  BACKGROUND
  ClinicalTrials.gov identifier: NCT00872417.
authors.affiliation: Department of Infection, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100730, China.
authors.forename: Ying
authors.initials: Y
authors.lastname: Cao
authors.forename: Yang
authors.initials: Y
authors.lastname: Han
authors.forename: Jing
authors.initials: J
authors.lastname: Xie
authors.forename: Qu
authors.initials: Q
authors.lastname: Cui
authors.forename: Lixia
authors.initials: L
authors.lastname: Zhang
authors.forename: Yijia
authors.initials: Y
authors.lastname: Li
authors.forename: Yanling
authors.initials: Y
authors.lastname: Li
authors.forename: Xiaojing
authors.initials: X
authors.lastname: Song
authors.forename: Ting
authors.initials: T
authors.lastname: Zhu
authors.forename: Taisheng
authors.initials: T
authors.lastname: Li
mesh_terms: D000225:Adenine / Q000009:adverse effects / Q000031:analogs & derivatives* / Q000627:therapeutic use; D000328:Adult; D019380:Anti-HIV Agents / Q000009:adverse effects* / Q000627:therapeutic use; D003404:Creatinine / Q000097:blood; D005260:Female; D005919:Glomerular Filtration Rate / Q000187:drug effects; D015658:HIV Infections / Q000097:blood / Q000188:drug therapy* / Q000503:physiopathology / Q000652:urine; D006801:Humans; D007668:Kidney / Q000187:drug effects / Q000503:physiopathology; D007674:Kidney Diseases / Q000139:chemically induced* / Q000503:physiopathology / Q000821:virology; D008297:Male; D008875:Middle Aged; D063065:Organophosphonates / Q000009:adverse effects* / Q000627:therapeutic use; D011446:Prospective Studies; D011480:Protease Inhibitors / Q000009:adverse effects* / Q000627:therapeutic use; D011507:Proteinuria / Q000139:chemically induced / Q000821:virology; D019438:Ritonavir / Q000009:adverse effects* / Q000627:therapeutic use; D018709:Statistics, Nonparametric; D000068698:Tenofovir
chemical_list: D019380:Anti-HIV Agents; D063065:Organophosphonates; D011480:Protease Inhibitors; D000068698:Tenofovir; D003404:Creatinine; D000225:Adenine; D019438:Ritonavir